I was diagnosed with an underactive thyroid last October and started on 50mg Levothyroxine. In October T4 was 10 and TSS was 13.5. Was back in January for follow up blood tests and this time they checked for Antibodies. T4 was up to 16 and TSH had reduced to 4.4 and Antibodies were 388. Now at the time I did not know what the antibodies meant but afterwards googled it and saw about Hashimotos. I was feeling better for a few months and then went seemed to go backwards a bit so went back to my doctor in May to ask if I could get my thyroid checked again. I asked if the antibodies meant that I had Hashimotos and was told not necessarily! Results in May were T4 was 13 and TSH was 1.17 but I was also had a vitamin D deficiency. Due to get another blood test next week but not checking the thyroid as the doctor says it is now ok. Sorry I don't have any lab ranges to add to the above results. Periods have not been very regular which was one of the original reasons for getting my thyroid checked along with always being extremely tired but when I started taking levothyroxine they started again and then have stopped after a couple of months which was another reason why I wanted my thyroid checked again in May. I'm 44 so could be early menopause but I'm not convinced as they started again for a while when I started taking the levothyroxine. Any advise before I go back to the doctor?

15 Replies

  • Jay23,

    Thyroid peroxidase antibodies over range means you have autoimmune thyroid disease (Hashimoto's) which causes 90% of hypothyroidism. UK doctors are quite peculiar about using the term Hashimoto's and seem to prefer to describe it as autoimmune thyroiditis. 100% gluten-free diet may improve symptoms and reduce antibodies.



    You need a Levothyroxine dose increase to raise FT4 higher in range. It will lower TSH but some patients need TSH low, and some need it suppressed, in order to have good FT4. Read Dr. Toft's comments in Treatment Options thyroiduk.org.uk/tuk/about_... Email louise.warvill@thyroiduk.org.uk for a copy of the Pulse article if you would like to show it to your GP.

  • Hi Clutter, many thanks for your reply. What should the range be for antibodies? I'll be back at the doctor the week after the next blood test for results so will have to ask if my T4 should not be a little higher, don't want to appear to be trying to tell her how to do her job but I did think it was still a little low. I know I could be feeling better than I am but I am sure that the vitamin D has helped a little the last couple of weeks. Really fed up of feeling like "I can't be bothered" doing things. Also a higher dose might sort out the period problem, as I say it made a difference when I first started taking levothyroxine ie just 4 days after starting it.

  • P.S. should I take my medication on the morning that I have my blood test at 2pm?

  • Jay23,

    I would cancel that 2pm appointment as TSH is lowest then. Arrange an early morning fasting test (water only) as TSH is highest early and drops after eating and drinking.

    Levothyroxine should be taken after the blood draw.

  • Jay23,

    Antibody ranges differ area to area. >35 is positive in a lot of areas, >100 in my area, and I've seen >160 once. 388 is unequivocally positive.

    A dose increase to raise FT4 should improve lethargy.

    I noticed vast improvement in joint pain, fatigue and mood around 6 weeks after I supplemented vitD.

  • I wasn't able to move blood test from 2pm as there were not any early morning appointments for a couple of weeks. Didn't have anything to eat and didn't take levo until afterwards though.

    T4 is 11 and TSH is 10, FSH is also 54 (was 40 something in January, 72 in May). Levothyroxine has been increased from 50mg to 100mg and doctor wants me to start HRT. I've to get blood's checked again in six weeks, wanted to wait and see what the increase does before starting HRT as no other symptoms apart from lack of periods and raised FSH. No mention of vitamin D so I have them at home already so will keep taking them although they are 5000 and the ones the doctor gave me last month were only 800.

  • Jay23,

    TSH 10 certainly explains why you are lethargic and unwell. Your doctor has given you quite a large dose increase. If you feel uncomfortable cut back to 75mcg for a couple of weeks before trying 100mcg again. It will take 7-10 days to absorb the increased dose before it starts working on symptoms and up to six weeks to feel the full impact of the dose.

    I think FSH >40 confirms menopause. If/when you start HRT make sure you take it at least 4 hours away from Levothyroxine or opposite ends of the day if you can.

  • Thanks for the quick response and advice. Hopefully the increase will do the trick.

  • Hi Clutter, was just worrying a little. As I said, I couldn't get an appointment first thing for the blood tests so it was done at 2pm, didn't take my levothyroxine that morning and didn't have anything to eat until afterwards. The resent results were quite a bit different from the ones the previous month (again, that had been a 2pm blood test but took levo in the morning and would have had something to eat during the morning). Would that extra few hours if I had had a 9am appointment to 2pm have made that much of a difference, the doctor did ask if I had been taking it every day but I didn't mention that I hadn't taken it that morning.

  • Jay23,

    TSH would have been higher if you'd had a blood draw earlier.

    See how TSH fluctuates throughout the day and night in the link below:


  • Hi Jay23, antibodies and low Vit D3 are definite signs of Hashimotos. The antibodies are attacking your tissue, your Levothyroxine is helping at first as it's replacing the low hormones (a result of the attack) but unless you address what is actually causing these antibodies to attack your tissue you're always going to need to up your medication until the point your thyroid no longer functions.

  • Hi K1k1_belle, thanks for the reply. By what I have read so far does that mean going on a gluten free diet or can you give some advice on how to go about doing this. My Dad is already on a gluten free diet as he has dermatitis herpetiformis. My Mum also tries as she has Crohn's disease. All help much appreciated.

  • No probs Jay23, I'm happy to help. It took me a long time to get to get off gluten, I never knew about the connection and when I finally did get off it it was like night and day. From what I've learned gluten is made up of the same chains of protein as our thyroid tissue (or very similar anyway), when these proteins leaky into our gut by means of intestinal permeability (leaky gut) our immune system sees these proteins as invaders (they should not be leaking out) and launches an attack on them but also mistakingly attacks our thyroid tissues.

    Seeing as there is such a strong correlation between our gut and chronic diseases you have to start with your gut! It needs to heal! Hashimotos is a complex condition and normally consists of a few components - EBV (glandular fever), herpes, SIBO, Candida, IBS and food intolerances may need to be addressed as do Vit and Mineral deficiencies (again due to leaky gut). Adrenal Fatigue and Blood Sugar Imbalances may also need to be addressed but I found that starting with the gut and having a good clean (gluten/dairy & sugar free) diet fixed all that. People speak about stress causing Adrenal Fatigue but don't realise that a 'stress' on our body can come from food intolerances and bad gut bacteria. I believe getting your good and bad bacteria back in harmony is the turn around point of this illness.

    Hope that's not too much and makes a bit of sense. I know we have to get our levels right etc etc but if we don't deal with the underlying issues then you'll never HEAL (love that word, it's my new word)


  • Gosh, don't think I could give up sugar. I had read some about leaky gut and did actually buy apple cider vinegar but that was just before I was told about the vitamin D deficiency so only took it for about a week and then stopped as I did not want to try anything different while the doctor started me on vitamin D in case it altered anything before my next blood tests as there are some other things that she is checking for with them.

  • I can have honey and maple syrup all the processed white sugar is gone out of my diet. You'd be surprised how quickly you get used to it once you up your good fats and you'll be amazed at how sweet and enjoyable fruit becomes!!!

    I'm only off the sugar because I had a test done and showed an intolerance to it but I'd have given it up anyway as I also have Candida. I can reintroduce it once I heal my gut 👍🏼

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